Your rights
Surprise medical bills: your rights under the No Surprises Act and how to dispute a bill
Short answer
If you had emergency care, or an out-of-network doctor treated you at an in-network hospital, federal law limits your bill to your in-network copay, coinsurance and deductible. Without insurance, you can dispute a bill that is at least $400 above your good faith estimate within 120 days. Ask for an itemized bill and financial assistance first.
Quick guide
Which protection applies to your bill?
1. What kind of bill is it?
Did you sign a notice-and-consent form agreeing to out-of-network care from that provider?
Did you get a written good faith estimate before the care?
It points to the part of this page that fits, in the page's own words. Nothing you choose is saved or sent. Not legal advice.
Key points
- Insured
- For emergency care, an out-of-network provider at an in-network hospital or surgery center, and air ambulance flights, you owe only your in-network copay, coinsurance and deductible. The provider may not bill you the rest, and the only exception is a notice-and-consent form you can refuse to sign.
- Uninsured
- If you don't have or use insurance, you get a written good faith estimate before scheduled care. A bill at least $400 above it can go to the federal dispute process within 120 days of the bill, for a $25 fee.
- Any bill
- Ask for an itemized bill with the codes, appeal a denied claim within 180 days, and ask a nonprofit hospital for its financial assistance policy before it may send you to collections.
- Help
- The federal No Surprises Help Desk is 1-800-985-3059, 7 days a week. State insurance departments take complaints about state-regulated plans.
A surprise medical bill is a bill from a provider you did not choose, at a price your insurance did not agree to. Since January 1, 2022 the federal No Surprises Act bans most of them: for emergency care, for out-of-network doctors who treat you at an in-network facility and for air ambulances, you pay what you would have paid in network, and the provider and your plan settle the rest between themselves. If you have no insurance, the same law gives you a written estimate before care and a way to dispute a bill that comes in far above it.
Below: what the No Surprises Act protects, the consent form you can refuse, the good faith estimate and the $400 dispute rule, how to dispute any medical bill step by step, medical debt and your credit report, the extra rules in California, Texas, Florida and New York, and where to complain. This page explains the law; it is not legal advice about your bill. Part of our Money and debt guides.
What the No Surprises Act protects
The No Surprises Act took effect on January 1, 2022. It applies to most private health coverage: employer plans, including federal employee plans, and plans bought on the Marketplace or directly from an insurer. It does not cover short-term, fixed-indemnity or health-sharing plans, and people with Medicare, Medicaid, TRICARE, VA care or Indian Health Service coverage have their own protections against balance billing. CMS: Medical bill rights · CMS: Know your rights when using insurance
- Emergency care, at any hospital. For emergency services at a hospital emergency department or a freestanding emergency department, an out-of-network facility and the out-of-network providers who treat you there must not bill you, or hold you liable, for more than the cost sharing you would owe in network.42 U.S.C. § 300gg-131 · 45 C.F.R. § 149.410(a)
- Out-of-network doctors at an in-network facility. If you have non-emergency care at an in-network hospital, hospital outpatient department or ambulatory surgical center, an out-of-network provider who treats you there (the anesthesiologist, the radiologist, the assistant surgeon, the lab) may not bill you more than your in-network cost sharing, unless you validly signed the notice-and-consent form described below.42 U.S.C. § 300gg-132 · 45 C.F.R. § 149.420(a)
- Air ambulance. An out-of-network air ambulance provider may not bill you more than the in-network cost-sharing amount for the flight.42 U.S.C. § 300gg-135
- You pay the in-network amount only. Cost sharing means your copay, coinsurance and deductible. The plan and the provider settle the rest through negotiation or the federal dispute process, without you.CMS: Know your rights when using insurance
- Not covered: ground ambulances and a doctor's own office. Ground ambulance rides are not covered by the federal act unless your state protects you. The protections also do not apply at an out-of-network facility you chose, or at a doctor's office that is not a hospital outpatient department.CMS: Know your rights when using insurance
The notice-and-consent form: what you can refuse to sign
An out-of-network provider at an in-network facility can ask you to give up the protection, but only in writing, on the federal form, handed to you separately from any other paperwork. The notice must say the provider is out of network, give a good faith estimate of what it may charge, say that signing is optional and that you may instead ask for an in-network provider at in-network cost. It must be offered in any of the 15 most common languages in your state, with an interpreter if needed. 45 C.F.R. § 149.420(c), (d), (f)
- Timing. If your appointment was made at least 72 hours ahead, the notice must reach you at least 72 hours before the care. If it was made within 72 hours, the notice must come on the day the appointment is made, and for same-day care no later than 3 hours before. 45 C.F.R. § 149.420(c)(1)(iii)
- Who can never ask you to sign. Providers of emergency medicine, anesthesiology, pathology, radiology, neonatology and diagnostic services such as lab tests and imaging; assistant surgeons, hospitalists and intensivists; any out-of-network provider when no in-network provider is available at the facility; and anyone treating an unforeseen urgent need that comes up during the care. For these services the in-network limit always applies, even if you signed something. 45 C.F.R. § 149.420(b)
- After an emergency. Once you are stable, a provider may ask you to consent to out-of-network follow-up care only if the treating doctor finds you can travel to an in-network provider without an ambulance and you are in a condition to give informed consent. 45 C.F.R. § 149.410(b)
- You can say no. Consent must be voluntary, and you can revoke it in writing before the care. Until you sign, the in-network limit applies. 45 C.F.R. § 149.420(c)(2)
No insurance, or paying yourself: the good faith estimate and the $400 dispute rule
If you have no health coverage, or you have coverage but tell the provider you will not use it, you are an uninsured (or self-pay) individual under the law. Every provider and facility must then give you a written good faith estimate of the expected charges before scheduled care, and whenever you ask for one, even by asking about the cost. 42 U.S.C. § 300gg-136 · 45 C.F.R. § 149.610(a), (b)(1)
| When | The estimate is due |
|---|---|
| Care scheduled at least 3 business days ahead | Within 1 business day of scheduling. 45 C.F.R. § 149.610(b)(1)(vi)(A) |
| Care scheduled at least 10 business days ahead | Within 3 business days of scheduling. 45 C.F.R. § 149.610(b)(1)(vi)(B) |
| You ask for an estimate | Within 3 business days of the request. 45 C.F.R. § 149.610(b)(1)(vi)(C) |
The estimate must list, provider by provider, each item or service expected for the care with its diagnosis and service codes and expected charge, and it must tell you about the dispute process. Keep it: the provider must keep a copy for 6 years and give it to you on request. 45 C.F.R. § 149.610(c), (f)
- The $400 rule. If a provider's or facility's total bill is at least $400 more than the total it put on your good faith estimate, the charges are substantially in excess of the estimate and you can start the federal patient-provider dispute resolution process. A difference of $399 or less does not qualify for the federal process; you can still negotiate and ask for an itemized bill. Each provider on the estimate is compared separately.42 U.S.C. § 300gg-137 · 45 C.F.R. § 149.620(a)(2)(ii), (b)
- The deadline: 120 days. Your notice must be postmarked or submitted within 120 calendar days of receiving the first bill with the excess charges. Start it online at the CMS dispute portal, or by mail or fax on the CMS form, with a copy of the bill and the estimate.45 C.F.R. § 149.620(c)(1), (c)(2) · CMS: Dispute a medical bill
- The fee: $25. You pay a $25 non-refundable administrative fee to the dispute resolution entity, and the process does not start until it is paid. If the decision goes your way, the $25 comes off what you owe; in a settlement the provider credits at least half of it.45 C.F.R. § 149.620(g) · CMS: Dispute a medical bill
- While the dispute is pending. The provider must not move the bill to collections or threaten to, must stop collection if it already started, must suspend late fees, and must not retaliate against you for using the process.45 C.F.R. § 149.620(c)(5), (c)(6)
- What the reviewer decides. An independent dispute resolution entity decides, item by item, within 30 business days of getting the provider's papers. If the provider cannot show that the extra charge was for a medically necessary item that could not reasonably have been anticipated, you pay the estimated amount. The decision is binding, and your costs cannot go up because you disputed.45 C.F.R. § 149.620(f) · CMS: Dispute a medical bill
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How to dispute any medical bill, step by step
Whether or not the No Surprises Act applies, the same six moves get most bills corrected, reduced or paid over time. Do them in writing where you can, and keep every letter and the date you sent it. CFPB: What should I do if I can't pay a medical bill?
- Make sure you owe it, and ask for an itemized bill. Check that the bill is yours, that you did not already pay it, and ask for an itemized list of every charge with the billing codes. Texas providers must send an itemized bill in plain language before they can collect, and Florida hospitals within 7 days of discharge or your request. Look for the same service billed twice, services you did not receive, and codes that do not match the care.
- Compare it with the explanation of benefits. If you have insurance, match the bill against the plan's explanation of benefits. For emergency care, an out-of-network provider at an in-network facility or an air ambulance, the amount you owe should be your in-network cost sharing and nothing more. If the provider billed you the balance, tell the provider and the plan in writing that the No Surprises Act applies.
- Appeal a denial within 180 days. If the plan denied the claim or paid less than it should, file an internal appeal in writing within 180 days (6 months) of the denial notice. The plan must decide within 30 days for care you have not had yet and 60 days for care you already had, and within 72 hours in urgent cases. If the plan still says no, you can ask for an independent external review within 4 months of the final denial; it is decided within 45 days, and the plan must follow it. Disputes about whether the plan applied the surprise-billing protections correctly can go to external review.
- Ask for financial assistance. Every nonprofit hospital must have a written financial assistance policy that says who qualifies for free or discounted care and how to apply, and must publicize it. It may not sell your debt, report you to a credit bureau, sue you or garnish your wages before it has made reasonable efforts to find out whether you qualify: it must wait at least 120 days after the first post-discharge bill, accept applications for 240 days, and give you 30 days' written notice before any of those steps.
- Negotiate, and ask for a payment plan. Ask the billing office to reduce the bill, and ask whether it will accept an interest-free repayment plan. Be careful about moving the bill to a credit card or a medical credit card: the interest can be high and you may lose the ability to negotiate.
- Complain if the rules were broken. Submit a complaint to the federal No Surprises Help Desk online or at 1-800-985-3059 for a surprise bill or a missing good faith estimate, and to your state insurance department for a state-regulated plan (the numbers are in the state table below).
Medical debt, collectors and your credit report
The Consumer Financial Protection Bureau says that unpaid medical debt that is more than 365 days delinquent from the date of service and over $500 could appear on your credit reports, so review your reports and dispute any error. What the three nationwide credit bureaus do with smaller or newer medical collections is their own policy, not a legal rule stated on the bureau's page, so check your reports rather than assume. CFPB: Do medical bills affect my credit?
- A collector may not collect more than the law allows. If a collector is trying to collect an amount that exceeds what the No Surprises Act permits, a collector cannot misrepresent that you must pay it. Dispute the debt in writing with the collector as soon as possible; that protects your rights under the Fair Debt Collection Practices Act and puts the collector on notice. CFPB: debt collection and credit reporting after a medical bill goes to collections
- Your 30 days. When a collector first contacts you, you have 30 days to dispute the debt in writing and the collector must pause while it verifies it: see Debt collector calls.
- If you are sued. Do not ignore the papers: see When a collector sues.
- A wrong entry on your report. Dispute it with the credit bureau and the company that reported it: see Mistakes on your credit report.
The extra rules in California, Texas, Florida and New York
The federal act is the floor. Each of the four states adds rules for plans it regulates and for hospitals; self-insured employer plans follow only the federal act. All checked against the state's own site on October 21, 2026. CMS: Know your rights when using insurance
| Rule | California | Texas | Florida | New York |
|---|---|---|---|---|
| State surprise-billing law | AB 72, since July 1, 2017: non-emergency care from an out-of-network provider at an in-network hospital, surgery center, lab or imaging center costs you only your in-network copay, coinsurance or deductible, and it counts toward your deductible and out-of-pocket maximum. Written consent to go out of network must be on a separate form signed at least 24 hours before care, with a written estimate. Applies to plans regulated by the Department of Insurance or the Department of Managed Health Care; not Medi-Cal, Medicare or self-insured plans. Emergency care is outside AB 72 (the federal act covers it). California Department of Insurance: AB 72 | Senate Bill 1264: for state-regulated plans, an out-of-network emergency provider may not bill an insured in, and the insured does not have financial responsibility for, an amount greater than an applicable copayment, coinsurance, and deductible; the provider and the plan settle the rest in mediation (facilities) or arbitration (doctors). Tex. Ins. Code § 1301.0053(b) · Tex. Ins. Code ch. 1467, §§ 1467.051, 1467.084 | For emergency services, and for non-emergency services at a facility that has a contract with your insurer when you had no ability and opportunity to choose a participating provider there, you owe only copayments, coinsurance and deductibles, and the nonparticipating provider may not collect or attempt to collect from the insured, directly or indirectly, any excess amount. Fla. Stat. § 627.64194(2), (3), (5) | A surprise bill is an out-of-network provider at an in-network hospital or ambulatory surgical center, or a referral by an in-network doctor to an out-of-network provider without your written consent. Send the Surprise Medical Bill Certification Form to your plan and the provider; you pay only in-network cost sharing, and the provider and plan go to independent dispute resolution. New York Department of Financial Services |
| Hospital bills, charity care and collections | The Department of Insurance says a consumer who follows the plan's rules is protected from credit damage, wage garnishment and liens on a primary residence over a surprise bill. California's hospital charity-care law (the Hospital Fair Pricing Act) could not be read from an official site for this review, so ask the hospital for its written charity care and discount policy; nonprofit hospitals also follow the federal § 501(r) rules. California Department of Insurance: AB 72 · IRS: § 501(r) | Before asking you to pay or sending a bill to collections, a provider must send a written itemized bill in plain language, with each service, any billing codes and what the insurer paid, no later than the 30th day after it receives the insurer's final payment; a provider may not pursue debt collection against a patient unless it has complied, and its licensing board must discipline a provider that violates the rule. Tex. Health & Safety Code §§ 185.002, 185.003 | The hospital must give you an itemized statement in plain language within 7 days after discharge or your request. It may not take extraordinary collection action before it has made reasonable efforts to determine whether you are eligible under its financial assistance policy, before it has given you the itemized bill, or for 30 days after notifying you in writing by certified mail or another traceable method. Fla. Stat. §§ 395.301, 395.3011(2) | Hospitals must offer financial aid regardless of immigration status: below 200% of the federal poverty level all charges are waived; 200% to 300%, you pay at most 10% of what Medicaid would pay; 301% to 400%, at most 20%. No lawsuit or collection referral for at least 180 days after the first bill, no suits against patients under 400% of the poverty level, 30 days' written notice before a collection referral, no forced sale of your home, and installment plans capped at 5% of your gross monthly income with interest of no more than 2%. N.Y. Pub. Health Law § 2807-k(9-a) |
| If you are uninsured | The federal good faith estimate and $400 dispute rule. 45 C.F.R. §§ 149.610, 149.620 | The federal good faith estimate and $400 dispute rule, plus the Texas itemized-bill rule above. 45 C.F.R. §§ 149.610, 149.620 · Tex. Health & Safety Code § 185.002 | A hospital must give a written good faith estimate no later than 3 business days after you ask (Florida ties its newer estimate rules to the federal rule). Fla. Stat. § 395.301 · 45 C.F.R. § 149.610 | An uninsured patient billed an excessive amount for emergency services can dispute it through the state's independent dispute resolution process; the fee is up to $495 unless household income is below 250% of the federal poverty level. New York Department of Financial Services |
| Where to complain | Your plan first; if it is not fixed, the Department of Insurance at 1-800-927-4357 (insurance.ca.gov), or the Department of Managed Health Care for its plans. California Department of Insurance: AB 72 | Your plan first, then the Texas Department of Insurance (its consumer page could not be reached for this review; use the federal help desk if you cannot reach it). Tex. Ins. Code ch. 1467 | Disputes over what the provider is paid go to court or the state's voluntary dispute resolution process; for your own bill, use the federal help desk at 1-800-985-3059. Fla. Stat. § 627.64194(6) · CMS: Submit a complaint | The Department of Financial Services at (800) 342-3736. New York Department of Financial Services |
Where to complain
- Federal: the No Surprises Help Desk. Call 1-800-985-3059, 7 days a week, in more than 350 languages, or submit the complaint online. Have the bill, a photo of your insurance card, the explanation of benefits and your good faith estimate ready; the help desk contacts you within 60 days if it needs more. CMS: Medical bill rights · CMS: Submit a complaint
- Your state insurance department for a state-regulated plan: the numbers for California and New York are in the table above.
- The Consumer Financial Protection Bureau for a collector or a credit bureau: see Debt collector calls.
What the billing office may say, and what you can say
“The anesthesiologist isn't in your network, so that part of the bill is yours to pay.”
You can say: “I was treated at an in-network hospital. Under the No Surprises Act I owe only my in-network cost sharing for an out-of-network provider there. Please bill my plan for the rest and send me written confirmation.”
“You signed the consent form.”
You can say: “Please send me a copy, with the date and time I received the notice. Anesthesiology cannot be waived by that form.”
“Pay today, or it goes to collections.”
You can say: “I am disputing this bill. Please send me an itemized bill with the billing codes, and your financial assistance policy and application.”
“We can't lower the amount.”
You can say: “I would like to apply for financial assistance, and if that is denied, an interest-free payment plan I can afford.”
“You didn't have insurance, so the estimate doesn't matter.”
If that is your situation, you can say: “The bill is more than $400 above the good faith estimate you gave me, so I am starting the federal dispute process within the 120 days. Until it is decided you cannot send this to collections.”
Getting help
Most bills are settled with a letter, an appeal and a financial assistance application. Talk to a lawyer or legal aid if you are sued, if your wages are garnished, or if the amount is large and the hospital refuses to apply its own policy.
If you lost job-based coverage, COBRA or a Marketplace plan can keep you insured; you generally have 60 days to elect COBRA.
Common questions
Can a hospital send me to collections?
Eventually, yes, but with limits. A nonprofit hospital must wait at least 120 days after the first post-discharge bill, make reasonable efforts to check whether you qualify for financial assistance, and give 30 days' written notice before selling the debt, reporting it, suing or garnishing. While a federal good faith estimate dispute is pending, no provider may send that bill to collections. New York hospitals must wait at least 180 days, and Florida hospitals must screen you for financial assistance and give you an itemized bill first.
Do I have to pay a bill my insurance denied?
Not before you appeal. File an internal appeal within 180 days of the denial; the plan decides within 30 or 60 days. If it still denies, ask for an external review within 4 months; the reviewer's decision binds the plan. If the denial is about a surprise bill, say so: whether the plan applied the No Surprises Act is a question external review can decide.
What is a good faith estimate?
A written, itemized estimate of expected charges that every provider must give an uninsured or self-pay patient before scheduled care, within 1 business day of scheduling (3 business days if the care is at least 10 business days away) or within 3 business days of a request. If the final bill is at least $400 more than the estimate, you can dispute it.
How long do I have to dispute a medical bill?
For the federal dispute process (uninsured, bill at least $400 above the estimate): within 120 calendar days of the first bill. For an insurance denial: an internal appeal within 180 days, then an external review within 4 months. For a collector: dispute in writing within 30 days of the first contact to make it pause. There is no deadline for asking for an itemized bill or financial assistance, so ask right away.
Can they charge interest on a medical bill?
No federal rule caps interest on a medical bill, but while a federal good faith estimate dispute is pending the provider must suspend late fees, and the CFPB warns against moving a bill to a high-interest credit card. New York caps interest on hospital installment plans at 2% and payments at 5% of your gross monthly income.
What if I was never told the doctor was out of network?
If the care was an emergency, or it happened at an in-network hospital, outpatient department or surgery center, the No Surprises Act limits you to in-network cost sharing whether or not anyone told you. The provider can only charge more if you signed the federal notice-and-consent form in time, and never for anesthesiology, radiology, pathology, lab work, emergency medicine, neonatology, assistant surgeons, hospitalists or intensivists.
Does the No Surprises Act cover ambulances?
Air ambulances, yes: you owe only in-network cost sharing. Ground ambulances are not covered by the federal act, so a ground ambulance bill depends on your state's law and your plan.
Who do I call about a surprise medical bill?
The federal No Surprises Help Desk at 1-800-985-3059, 7 days a week, or the online complaint form. For a plan regulated by your state, also call the state insurance department: in California 1-800-927-4357, in New York (800) 342-3736.
Official sources
- CMS: Medical bill rights (the No Surprises Act, in effect since January 1, 2022; good faith estimates; the $400 rule; help desk 1-800-985-3059, 7 days a week) cms.gov
- CMS: Know your rights when using insurance (emergency care, out-of-network providers at in-network facilities, air ambulance, the notice and consent form, providers who can never ask you to sign, ground ambulances, 90 days of continued care) cms.gov
- CMS: Dispute a medical bill (the patient-provider dispute resolution process: at least $400 above the estimate, within 120 calendar days of the bill, the $25 fee, no collections while pending) cms.gov
- CMS: Submit a complaint (online form; 1-800-985-3059; what to have ready; a reply within 60 days if more is needed) cms.gov
- CMS: No Surprises Act, consumers (in effect January 1, 2022; help desk phone support 7 days a week) cms.gov
- CMS: Understanding costs in advance (good faith estimates when care is scheduled at least 3 business days ahead; disputing a bill at least $400 more than the estimate) cms.gov
- 45 C.F.R. § 149.410: balance billing in cases of emergency services, § 149.410(a) and (b), October 1, 2025 edition (PDF) govinfo.gov
- 45 C.F.R. § 149.420: balance billing for non-emergency services by nonparticipating providers at in-network facilities, § 149.420(a), (b) ancillary services, (c) notice and consent (72 hours, 3 hours), (c)(1)(iii), (c)(2), (d), (f), October 1, 2025 edition (PDF) govinfo.gov
- 45 C.F.R. § 149.610: good faith estimates for uninsured or self-pay individuals, § 149.610(a), (b)(1), (b)(1)(vi)(A), (b)(1)(vi)(B), (b)(1)(vi)(C), (c), (f) (1 business day, 3 business days, 10 business days, 6 years), October 1, 2025 edition (PDF) govinfo.gov
- 45 C.F.R. § 149.620: the patient-provider dispute resolution process, § 149.620(a)(2)(ii) substantially in excess ($400), (b), (c)(1) 120 calendar days, (c)(2), (c)(5), (c)(6), (f), (f)(1)(ii), (g) the administrative fee, October 1, 2025 edition (PDF) govinfo.gov
- 45 C.F.R. § 147.136: internal claims and appeals and external review, § 147.136(b), (c)(2)(vi), (d)(1)(i)(B), (d)(2)(i) (four months to request external review; 45 days; 72 hours), October 1, 2025 edition (PDF) govinfo.gov
- HealthCare.gov: Internal appeals (file within 180 days, 6 months, of the denial; decided within 30 days before care or 60 days after; 72 hours for urgent care) healthcare.gov
- HealthCare.gov: External review (request within 4 months of the final denial; decided within 45 days, 72 hours if expedited; binding on the insurer) healthcare.gov
- 42 U.S.C. § 300gg-131 (Public Health Service Act § 2799B-1): balance billing in cases of emergency services govinfo.gov
- 42 U.S.C. § 300gg-132 (§ 2799B-2): non-emergency services by nonparticipating providers at participating facilities; notice and consent (72 hours); ancillary services govinfo.gov
- 42 U.S.C. § 300gg-135 (§ 2799B-5): air ambulance services govinfo.gov
- 42 U.S.C. § 300gg-136 (§ 2799B-6): good faith estimates on request and for scheduled appointments (3 business days, 1 business day, 10 business days) govinfo.gov
- 42 U.S.C. § 300gg-137 (§ 2799B-7): patient-provider dispute resolution for bills substantially in excess of the estimate govinfo.gov
- IRS: Billing and collections, section 501(r)(6) (extraordinary collection actions; reasonable efforts; the 120-day notification period and 240-day application period from the first post-discharge bill; 30 days' written notice) irs.gov
- IRS: Financial assistance policies, section 501(r)(4) (what a nonprofit hospital's written policy must include and that it must be widely publicized) irs.gov
- CFPB: What should I know about debt collection and credit reporting if my medical bill was sent to collections? (a collector cannot misrepresent that you must pay more than the No Surprises Act permits; dispute in writing) consumerfinance.gov
- CFPB: Do medical bills affect my credit? (unpaid medical debt more than 365 days delinquent and over $500 could appear on your credit reports) consumerfinance.gov
- CFPB: What should I do if I can't pay a medical bill? (itemized bill, charity care at nonprofit hospitals, interest-free payment plans, credit card caution, the No Surprises Act) consumerfinance.gov
- California Department of Insurance: Consumer protection from surprise medical bills, AB 72 (since July 1, 2017; in-network cost sharing only; written consent at least 24 hours before care; no credit damage, garnishment or liens; help line 1-800-927-4357) (PDF) insurance.ca.gov
- Texas Insurance Code, Chapter 1301, § 1301.0053(b): an out-of-network emergency provider may not bill an insured more than the copayment, coinsurance and deductible tcss.legis.texas.gov
- Texas Insurance Code, Chapter 1467: out-of-network claim dispute resolution (§ 1467.051 mediation, § 1467.084 arbitration, amounts for which an enrollee may not be billed) tcss.legis.texas.gov
- Texas Health and Safety Code, Chapter 185, §§ 185.002, 185.003: itemized bill in plain language before payment is requested or collection begins (30th day after the insurer's final payment; disciplinary action) tcss.legis.texas.gov
- Florida Statutes § 627.64194 (2026): coverage requirements for services by nonparticipating providers; payment collection limitations, § 627.64194(2), (3), (5), (6) flsenate.gov
- Florida Statutes § 395.301 (2026): price transparency; itemized patient statement or bill within 7 days; good faith estimate within 3 business days of a request flsenate.gov
- Florida Statutes § 395.3011 (2026): billing and collection activities, § 395.3011(2) (no extraordinary collection action before checking financial assistance eligibility, before an itemized bill, or for 30 days after written notice) flsenate.gov
- New York Department of Financial Services: Surprise medical bills and emergency services (in-network cost sharing only; the Surprise Medical Bill Certification Form; independent dispute resolution; uninsured patients, fee up to $495 unless income is below 250% of the poverty level; (800) 342-3736) dfs.ny.gov
- New York Public Health Law § 2807-k(9-a): hospital financial assistance (200%, 300%, 400% of the poverty level; 10% and 20% caps; 180 days before collection; 30 days' notice; installment plans at 5% of income, interest at most 2%) nysenate.gov
Related
This page explains the law in general terms. It is not legal advice about your situation. Justice is not a law firm and is not affiliated with any court or government agency.